Relationship between Vascular Enhancement, Cerebral Hemodynamics, and MR Angiography in Cases of Acute Stroke
Patrizia Pantano
,a,
Danilo Tonia,
Francesca Caramiaa,
Anne Falcoua,
Marco Fiorellia,
Corrado Argentinoa,
Luigi Maria Fantozzia and
Luigi Bozzaoa
a From the Neuroradiology Section (P.P., C.F., F.M., F.L.M.) and the Neurological Clinic I (T.D., F.A., A.C.), Department of Neurological Sciences, University of Rome "La Sapienza," Rome, and IRCCS Neuromed, Pozzilli (P.P., B.L.), Italy.
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FIG 1. MR images of patient 12, who was studied 1 hr after the onset of stroke.
A, MR angiogram (43/2.3/1 [TR/TE/excitations]) shows left MCA occlusion, mild caliber reduction of the supraclinoid tract of the left internal carotid artery with respect to the contralateral one, asymmetry in the A1 segments (right > left) with good filling of both the anterior cerebral arteries (A2 tracts), and left posterior cerebral artery filling out farther than the contralateral one.
B, Contrast-enhanced T1-weighted images (560/14/2) show marked vascular enhancement of the thin vessels in the left superficial frontotemporal region.
C, Diffusion-weighted image (left) (6000/64/1) shows early damage in the left deep MCA territory. The lesion extent is substantially unchanged on the follow-up MR image (right) (FLAIR image obtained 1 week later [6000/100/2]).
D, Perfusion-weighted maps show an increase of both rCBV (left) and MTT (right) in the left superficial MCA territory, outside the area of altered diffusion-weighted imaging (outlined). The rCBV and MTT asymmetries were 105% and 54%, respectively.
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